When every pediatrician refuses to care for kids that haven’t been vaccinated, as this one does, maybe some of these woo woo loons will decide to change their minds, because they seem immune to science, common sense or the lessons of history.

anger doesn’t work–the delusional can summon more passion than you
tossing out facts just make their delusions stronger–scientifically proven to backfire!
but RIDICULE is an effective persuasion tactic in the fight against woo

Yes, ridicule makes some people angry, but it’s the only tactic I know of scientifically proven to change people’s minds when they’re stuck on delusion. I don’t mean ridiculing the person, but making the delusion seem ridiculous. Probably related to the “Huh? Huh? [Blank face]” tactic for your wingnut uncle at Thanksgiving.

@Another Holocene Human: Crazily (or perhaps the exact opposite) recent psychological research indicates than when presented with thoughtful, polite, well-reasoned arguments as to why someone’s sacred belief is hooey (in the experiment’s case, “vaccinations are harmful”), the subjects–instead of rationally changing their minds–doubled down in their delusion.

You have to make the woo seem so silly that the wooist actually feels silly believing it. Shunning the woomeisters and woomongers is fine, but that will NEVER persuade their followers that they’re wrong.

No, you have to make every word out of their mouth a laugh line. (I know it’s hard–we’re all angry about the real lives being destroyed by this shit… that will motivate us to make the laws stricter, but it won’t persuade anyone.)

Take the evil autism parent gish gallop about vaccines.

Every time the notion was tested they found no connection.
Every ingredient they said was the culprit was removed, and there was no change in prevalence.
They said Amish don’t get jabs and don’t get autism and both claims are untrue.
And now they can diagnose autism in the first month of life before vaccines are even administered.

The facts are there. Now let’s make them look silly.

Here’s an easy one–you could make a viral meme graphic with a dog looking quizzical or other cute animal or child–“So you’re saying it’s safer for me to catch live chickenpox and have a raging viral infection which will never actually go away than be injected with dead chickenpox and never get pox or shingles?”

Here’s an easy one–you could make a viral meme graphic with a dog looking quizzical or other cute animal or child–”So you’re saying it’s safer for me to catch live chickenpox and have a raging viral infection which will never actually go away than be injected with dead chickenpox and never get pox or shingles?”

OK, gotta take that one. You can still get the disease. Case in point, my daughter had the varicella vaccine, and about 6 months later, got a case of the shingles. Her ped didn’t believe it could have been shingles, but then her brother got chickenpox a week later. (Both were mild cases and they recovered fine) I honestly don’t know how to impress on some idiots that herd immunity is real, and by not vaccinating their children, they’re putting EVERYONE at risk, even those who’ve been immunized.

Every ingredient they said was the culprit was removed, and there was no change in prevalence.

yes. now many of them are down to the ‘we’re overloading our babies with antigens and that’s what’s doing it! kids get so many more shots now!’ line.

when you point out that 1) due to improved formulations the total amount of antigens in the entire series is far below the amount in the fewer shots we got as kids, and 2) kids’ immune systems are exposed to orders of magnitude more stuff every single day just from environmental effects, they just glaze over.

you put your baby in a sandbox at the playground for 10 minutes and the kid’s immune system spends the rest of the day coding for more material than probably 10 fucking shots.

@chopper: it’s interesting, I’ve been reading up on the historicity of Jesus, because, well I watch too much History Channel and H2… the consensus is that Jesus was an actual person, based on the existence of the gospels and two random writings written long after Jesus died and not in the region. It actually baffles me that with as much scrutiny is paid to so much else from human history, that this is all it takes to prove that Jesus lived.

@chopper: It’s gotten insidious. The medical establishment’s first reaction to anti-vaxxers was to ignore them, then it became an ear worm, and now it’s a religion. Extricating people from their religion is very, very hard. And now the medical profession is taking notice, but a lot of the damage has been done, and it’s going to be another generation before the dumb-fcuks in ours die off and take their idiocy with them.

I remember having measles as a kid (I was a year or two shy of getting the vaccine.) It was a pretty miserable four days, but the thing that bugged me most was not being able to read or watch tv. It was believed that measles could weaken the eyes, not sure what the real
connection is with that.

As the father of an autistic child who was diagnosed in the mid 90’s just as their research was gaining steam, I will take some issue with the anger at the loons, many of whom, like myself were looking for answers. My son received his vaccinations all on schedule but within months of receiving MMR, he began to show significant changes. We saw many specialist and therapists, spent thousands and thousands of dollars looking for answers. When an endoscopy discovered what the doctor described as a measles colony in his upper intestines, then his physical ailments began to make sense. His intolerance of milk proteins and how grains consumed in public could set off his sensory overload resulting in bouts of uncontrollable screaming in restaurants that can’t be explained otherwise.

And it gave the naysayers some credibility.

Subsequent research, however, proved to not bear out our suspicions and our belief that the vaccinations led to his development of autism faded.

Don’t be so angry at the early adopters of this belief. It was an agonizing time and there were valid suspicions that did, at one time, point in that direction.

@KG: Bart Ehrman has a wonderful lecture series exploring the historical Jesus. I personally think that Jesus is almost entirely fictional (but I don’t have a dog in this fight), but his lectures do a good job exploring what historians can say about Jesus with higher degrees of certainty.

When every pediatrician refuses to care for kids that haven’t been vaccinated, as this one does, maybe some of these woo woo loons will decide to change their minds physicians and look for someone stupid driven enough to self-certify

More like it.

See: Paul, Rand, for an example of a medical “professional” who doesn’t like the medical community’s consensus.

While I agree with this good physician’s understandable sense of outrage, I am concerned about the precedent of doctors turning away certain types of patients. It reminds me of some of the odious types of behaviors shown by some medical providers at the start of the AIDS epidemic.

Yes the parents are ignorant ass holes, but the kids are victims and there has to be a way to provide them the needed care in a professional way that does not compound their victimization.

@Keith G: I don’t agree. She has to protect her ALL her patients. And vaccinations are about societally putting the needs of the many ahead of the desires of the few. I can understand how she cannot in good conscience administer to patients who are going to put herself and her other patients at risk of serious infection.

@Keith G: Wrong–the physician has a duty to protect the many pregnant women and infants in the practice. This is no different than having a sign at the entrance of the hospital reminding people that if you think you are highly contagious you need to take precautions before entering. The kinds of people who are likely to be in a doctor’s waiting room–let alone the doctors and nurses themselves–are quite likely to be immunocompromised in some way (too old, too young, or sick).

anger doesn’t work–the delusional can summon more passion than you
tossing out facts just make their delusions stronger–scientifically proven to backfire!
but RIDICULE is an effective persuasion tactic in the fight against woo

Which is among the reasons Mrs. Boonstra and other die-hard red voters are completely impervious to any sort of objective, or realistic evidence-based refutations to their claims and objections to Obamacare. They’d have to let go of their delusional, passionately hate-filled belief system.

His intolerance of milk proteins and how grains consumed in public could set off his sensory overload resulting in bouts of uncontrollable screaming in restaurants that can’t be explained otherwise.

Ironically, given what we now know about food intolerances, it most likely was a straight-up pain reaction to the lactose and gluten. Before I figured out I was lactose intolerant, the massive abdominal pain after eating dairy was sometimes enough to make me cranky and snappish, so I can only imagine how much worse it was for an autistic kid to be in that kind of pain and unable to express his feelings appropriately.

And, frankly, the problem is not really parents with autistic kids anymore, because most of them are getting the correct information from their doctors. The problem is with parents who fear that something will magically turn their special snowflakes autistic even though we now know that’s not how it works.

@KG: The historicity of an amazing number of people you think are firmly established in ancient history isn’t based on much more than that. That’s just how it is with ancient history.

You have one or two writers whose books survived the burning of the Great Library, the Crisis of the Third Century, Dark Ages, the Mongels, and the Inquisition, and maybe three or four more based on those sources. After the 19th Century, those accounts were often buttressed out with inferences from excavated inscriptions and coins, but even that’s pretty thin.

The evidence for the historicity of Hannibal isn’t much better than that for Jesus. You have on semi-contemporaneous, Polybius, and the fact that Romans kept talking about him for centuries thereafter . We have one contemporaneous account of the Peloponnesian Wars, part of which is lost. No one can tell you precisely where the Cannae battlefield was.

The truth is that almost all of ancient history is very much a common agreement to believe a common story woven from a tiny handful of fragmentary and often non-contemporaneous writings because the alternative is to abandon an important source of cultural continuity and identity as insufficiently proven.

That said, however, if the secondary evidence for the existence of Hannibal is that Romans started talking about him at about the time he was said to have lived and kept talking about him for centuries thereafter, then you’ve got to say the same about Jesus. No matter what Aldous Huxley said, that religion didn’t just spring up out of nowhere in the First Century AD.

When every pediatrician refuses to care for kids that haven’t been vaccinated, as this one does…

Mine does, and I’m really glad. It means that (a) my 3-month-old is safer when I take him into the waiting room than he might be otherwise, and (b) I won’t have to have conversations with anti-vaxxers in the waiting room. Both of those factors make significant contributions to my peace of mind.

Let’s extend the AIDS metaphor you brought up. Would an AIDS doctor be justified in dropping one of his patients because the patient refused to use a condom or inform any of his partners that he has AIDS, or must that doctor continue to see that patient regardless of that patient’s actions that endanger himself and others?

Here’s the question you need to be asking, though: how does proving that Jesus was a historical person also prove that he was the Son of God? We already know that Buddha, Mohammed, Joseph Smith, and L. Ron Hubbard were historical persons — does that mean that all of their religious claims are automatically true?

If there was a real person who can be identified as the historical figure we now call Jesus, it doesn’t automatically give extra credence to Christianity any more than the historical L. Ron Hubbard automatically gives extra credence to Scientology.

@Keith G: So what do you suggest the doctor do? Vaccinate the kid in secret? Put up a sign in his office that says “I treat unvaxxed children, enter at your own risk”? Pray that one of those kids doesn’t infect the delicate 11 month old who already has a weakened inmune system?

These people are NOT LISTENING. It’s almost as if they cling to the idea that the vaccines must be doing something because otherwise it would be their fault. So do we continue to expose everyone else in order to feed their delusions of control?

Wikipedia has a page up listing prominent antivaxxers. I confess I’ve never heard of most them, but of those whose names I recognized, there were no surprises. Sad that RFKJr. has chosen to align himself with the likes of McCarthy, Limbaugh, and Scarborough.

ETA: I’ve known for a long time that RFKJr was antivax. Did not know it about Scarborough.

@Xboxershorts:
Two things.
First, all the best for your son and for you in caring for him.
Second, This is the difference, you learned. Suspicion is good, it is a part of the base of science, questioning evidence is vital. But so is accepting of the evidence. But it may be that too many things have happened, too many things government has done which has ruined confidence in it. Some recent, some a couple of generations ago, torture, experiments on unknowing groups for example. And then we have mass marketing, that makes many think/feel that say an actor or a financial broker or…. is well, superior.

@Another Holocene Human: Ugh, I know. We have an old family friend. They have a masters degree in a health-related discipline from a prestigious southern California university. They, and their ex (also of similar education) didn’t vaccinate their child. Drove me nuts. I didn’t take our kids to see them until mine had had had all their shots, so it was years between visits.

When Wakefield was thoroughly discredited, I brought it up with them, and they gave me that “oh shit” stare, then changed the subject. Makes me cringe just thinking that there are children out there that I care about who are at risk and who are putting others at risk as well.

@Xboxershorts: Generally the first visible signs of autism start a year or two after the kid is born. That’s also the usual timeframe for the MMR vaccine. Speaking AS a person with autism whose parents experienced the same panic and frustration that you did with your son, it’s understandable that you’d want to know what the heck happened to your son who was behaving so normally just a little while ago. It’s rather tragic that enough people mistook correlation for causation where the MMR vaccine is concerned. It’s an obvious target to point your finger at since it is usually administered right around the time when a young child first starts showing signs of autism. If not for all the preventable deaths and illness they’ve caused, I’d be able to feel sympathy for the anti-vaccination movement.

@Keith G: What then do you suggest? Shooing the offending parent and unfortunately non-immunized child is not a solution; turning the child over to protective services seems both excessive and more problematic than doing nothing; shaming the parent in the medical office will do more harm than good; and the medical community has obviously not succeeded in refuting anti-vaxxers sufficiently to stop the behavior. While it’s tempting to let them go on as they are with the assumption that Teh Stupid will succumb to polio/whooping-cough/flu/whatever, even if you hadn’t pointed out the precedent, actually allowing that would not be particularly palatable either.

@Belafon: I wouldn’t try that argument. It bounces right off people. I make the same argument about guns in cities, saying that my neighbor’s right to bear arms should not trump my right to not have a bullet fly through my wall and possibly kill me or a member of my family because neighbor was a dumbass while cleaning his loaded gun. It never works. To some people, the right of individual freedom trumps the right of the people around that individual free person to live.

I didn’t think he was — I was more presenting the arguments that may have some force with Christianists who will be running around screeching that the fact that there was a historical person identified with Jesus totally proves all of the tenets of fundamentalist Christianity are 100 percent right. If having an identifiable historical person as the founder of your religion is all it takes to prove your religion is All True, than it also proves that Buddhism, Islam, Mormonism, and Scientology are 100 percent right, doesn’t it?

I know the unintended consequences but maybe parents should request the ID of unvaccinated children from schools and demand separate classes for the them. It sounds horrible but what other defense do people have against dangerously irrational positions other than ostracizing? Just the notion might push a reality based outlook.

@KG: There aren’t a ton of people from that era for whom we have really compelling evidence, so historians don’t set the bar that high. There probably was some guy named Jesus who gave some speeches and ended up crucified. Not unlikely. Obviously his miracles are suspicious and I’ve always thought Pontius Pilate’s portrayal is total BS, but I don’t see any reason to doubt Jesus existed.

Speaking of loons (I’m sorry to be going off-topic, but I’ve waited for hours and there hasn’t been a new open thread) TheUri Geller is claiming he has been invited to join the search for MH370, by some “substantial figure” in Malaysia whom he won’t name. I suspect he was really invited by Uri Geller.

Friends and family of MH370 First Officer Fariq Hamid dispute the Australian TV report that says he hit on female passengers. The friends and fam say Fariq is not like that at all, but rather a devout Muslim and a keen pilot.

Extending the search into the Indian Ocean means taking it into really deep waters, as deep as 7km. So far the search has been confined to the South China Sea, atop Asia’s continental shelf; the Gulf of Thailand where MH370 disappeared is less than 100m deep.

@boatboy_srq: It gets more complicated than that. It’s not like 100% of the people who accept vaccination can do it to their kids. There are plenty of medical conditions that preclude vaccination. Does that pediatrician refuse to treat kids with damaged immune systems? How about the one that survived a severe vaccine reaction? A sincere Christan Scientist?

The idea with vaccinating most people is to develop herd immunity so that the rare person with a disease for which there is a vaccine available is unlikely to run across another susceptible person. But there have always been children who, for their own particular health reasons, can’t be vaccinated. To close your practice to them seems rather dick-ish. Ditto judging the parent who tells you (so that you can protect your own kid) that their child isn’t vaccinated without getting into the whole lymphocytic leukemia thing.

@Xboxershorts: my mother always believed that my brother’s autism was related to vaccination, and that was 30 years before the anti-vaxxers came to prominence. And it was 20-odd years before he was diagnosed with autism. It’s a perfect example of the post hoc ergo propter hoc fallacy, human development proceeds in such a way that autism becomes obvious in most people right around the time they start being vaccinated. But you might as well blame it on having a full head of hair

@Mnemosyne: I always figured that having an identifiable historical person as founder made a religion more obviously false. Mormonism being a prime example in my book.

it’s like telling some uber-xtian that there’s no physical evidence that jesus ever existed.

There’s very little physical evidence that any long-dead person ever existed unless you go to the trouble of digging up their grave. There is frequently contemporary documentary evidence that long-dead people existed (e.g. baptismal records, proclamations by rulers, etc.) but it gets scantier for ordinary people the longer back in time you go.

The thing about Jesus is that there are no contemporaneous accounts of his life; all of the Gospels are from well after his death and are based on second-hand accounts. People will sometimes compare him to Alexander the Great, for whom there are also no remaining first-hand biographies. The obvious difference, of course, is that there’s tremendous historical evidence for Alexander’s existence, e.g. the cities named Alexandria, archeological evidence of Greeks all over the former Persian Empire, history involving Alexandrian successor states, etc. There’s no comparable historical evidence for Jesus.

There are plenty of stupid physicians out there. My stepmother was an early convert to the anti-vax movement in the mid-80’s. She read some book by an idiot physician (IIRC Harvard-trained as many of the most idiotic seem). The main points of his book was 1) you give people a disease when you give them a vaccine (yeah, that’s the idea) and 2) ya know what we’ve got a lot more of since we started giving lots of vaccines? cancer! therefore, vaccines cause cancer ispo facto ergo. Her first 2 kids with my dad had gotten most of their shots, but she decided not to get anymore vaccines for the kids. This also led her to then take the kids out of public schools & home school them since Arkansas had requirements for vaccinations. I could go on with other examples of her idiocy & paranoia…

@Capri: It’s not actually more complicated than that. Of course he’d treat kids with damaged immune systems. The major issue at hand is if a pediatrician should be seeing children of parents who announce their intention to deliberately ignore good medical advice on the basis of junk science and a dangerous fad. I’d say any doctor is within their rights to refuse to see patients who they know are not going to listen to what they say. We have enough frivolous malpractice suits as it is, the last thing a pediatrician wants is for a dumb parent to refuse their medical advice, have the kid get sick, and then blame the doctor for it. Even a meritless malpractice suit eats up a ton of time and money that the doctor would rather be using on cooperative patients.

@Xboxershorts: I think it was entirely reasonable at the time and with the state of research to investigate the hypothesis. That you discarded the hypothesis when it turned out to have no bearing is what makes you NOT an anti-vax loon.

But why does that mean we should go easy on anti-vaxxers now? With the information we have out now, you yourself said there’s no excuse anymore. Yet you take issue with our anger that they are risking the lives of others. I don’t understand that.

@Emma: “These people are NOT LISTENING. It’s almost as if they cling to the idea that the vaccines must be doing something because otherwise it would be their fault. So do we continue to expose everyone else in order to feed their delusions of control?”

I’ve rather thought it’s the same problem for religious belief. If there isn’t any god, then all of the morality judgments and justifications through the years have nothing to do with god but THEIR OWN GODS-BEDAMNED fears and delusions, the safety blanket they need to keep the illusion of control of their lives.

@Amir Khalid: They might end up using Bayesian search theory like was done searching for the USS Scorpion, but I think the variables would be greater since the Scorpion probably had a defined patrol area,

So if you’re going to crash the plane anyway, why the surreptitious flight path shenanigans? Are there places in those Indian Ocean islands you could land a jumbo jet full of people without anyone noticing for days? and if you could, why? I bet even Stephen King would be challenged to construct a plausible storyline with the info we now have without a supernatural cause.

Are anti-vaccine folks more left leaning or more right leaning? I can’t tell. It’s one movement that seems to appeal to conspiracy theorists from different political spectrums. I have a very liberal friend who insists the flu vaccine just gives you the flu and is useless. She’s not anti-vaccine, but rants every flu season about the flu vaccine. I was also surprised to find out Mayim Bialik doesn’t vaccinate her kids and she has a Phd in neuroscience.

What I don’t understand about the anti-vaccine folks is even if they believe there is a link between autism and vaccinations, kids at 5 or 6 years old don’t suddenly become autistic, so why not vaccinate your kids at the point they are ready to enter school?

In my experience, the anti-vaxxer contingent was primarily left-wing nutjobs (think: the worst stereotypes of vegan hippie Mother Gaia types), but over the past several years, right-wing notjobs have glommed onto the movement as well because, you know, freedom and liberty and evil lying scientists and the big gummit tyranny of innoculations.

patients whose parents refuse to vaccinate them are not welcome in my practice.

She is clearly implying that she is not precluding children from her practice who for known and understood health reasons, cannot be vaccinated, but only those whose parents “won’t” (in her words “refuse to”) vaccinate their children.

I was also surprised to find out Mayim Bialik doesn’t vaccinate her kids and she has a Phd in neuroscience.

Ah man, not Mayim, too! It’s hard to find a good celebrity to worship these days. Many of my favorite actors are nuts. With my luck, this probably means that Tiny Fey and Jimmy Fallon have some crazy-wing belief, too, but they’re doing a better job at concealing it.

@the Conster:
Military radar doesn’t communicate with civilian transponders and so the radar contacts do not positively ID the plane they think might be MH370, even though it used the common civil-aviation waypoints for routes to the west. So I guess it’s possible those contacts might really be some other plane.

Some of those Indian Ocean islands are tourist destinations themselves, and so might have airports with decently long runways.

As for stealing a 777, it seems both extremely difficult and pointless. To operate it yourself, you’d need vast quantities of jet fuel plus supplies and spare parts obtainable only from Boeing and Rolls Royce. If you flew it anywhere, someone would spot it. If you try to sell it, well, it’s a bit trickier than disposing of a stolen car.

My son, now age 8, is severely autistic. He has improved some over the last year, but it is likely that he will never be able to live on his own. Unlike many people, we did not have thousands and thousands of dollars to spend in special treatments. Unless you are the parent of an autistic child, YOU DO NOT KNOW WHAT THIS IS LIKE.

My son’s autism “kicked in” at 18 months, when he went from a child making above-average progress and speaking in complete sentences, to non-verbal and locked in his own world, in the space of about two weeks.

He had NOT had his 18-month MMR shots yet, so we never blamed the vaccines. SOMETHING happened, some combination of genetics and environmental factors. We don’t know what it was. But you know, if he had his MMR shots and then in the space of two weeks changed so profoundly, we might have very well blamed the shots.

We are not anti-vax people and both of our sons have had their full series of shots. I’ve read the research, and I am convinced that the vaccines have nothing to do with autism. The anti-vax people have been badly misled by charlatans like Wakefield and celebrity ignorasimi like McCarthy.

But something has changed over the last 30 years, some new factor added to the environment that is increasing the number of severe autism cases. It is not a matter of better diagnosis of marginal cases. My son’s pediatrician says that 20 years ago, he had only one patient similar to my son. Now he has dozens. And the population of our town (a highly-educated college town with a relatively clean environment) has not grown nearly enough to account for such a change.

@FDRLincoln: Am very sorry for what occurred to your son and the effects it is having on him, you and your family. As a parent I can understand the desire to find a definitive answer to “why” and as you note, one is probably not forthcoming. Biology? Environment? As you suggest, likely both.

IIUC the screening for autism is now both much better and much more widely conducted, so the higher recorded rates might in part be due to that, as well.

Would be an interesting sociology project. Anecdotally, I became first aware of this as a “thing” from Wadorf-schoolin’ hippie-type parents (’80s and ’90s) but for at least the last decade it’s been a proud belief of the foothill-dwellin’, home-schoolin’, food & ammo-hordin’ True Belivers. They are by far the most common I encounter these days.

Here’s the question you need to be asking, though: how does proving that Jesus was a historical person also prove that he was the Son of God?

I would flip it the other way around. Jesus can’t possibly have been the Son of God unless he existed, so it’s important for people who want to believe in the Bible as anything beyond a bunch of myths and allegories to show that he was an actual person.

@FDRLincoln: this sounds exactly like my brother’s story, except he’s a high functioning autistic. He will never live on his own. My mother said that she thought he was going to be the smartest one of us when he was a baby, and then it was like a switch was thrown and he was totally different. He generally scores under 70 on IQ tests. I have not idea what might cause that, but it’s like the infant form of a schizophrenic break. Humanity has definitely tempted fate with the way we have abused nature. However, my brother’s condition certainly seems organic to me now. He’s 53, btw.

@Trollhattan:as I posted up-thread, my brother wasn’t even diagnosed as autistic until IIRC, sometime in the ’80s. Before that he was considered to be schizophrenic, and the treatment he received was for schizophrenia, which was partially successful. Apparently his current diagnosis includes that to some degree, but secondary to his autism. It doesn’t surprise me that the rates of the diagnosis are still accelerating, it would be more concerning to me if that continued to occur

Jesus can’t possibly have been the Son of God unless he existed, so it’s important for people who want to believe in the Bible as anything beyond a bunch of myths and allegories to show that he was an actual person.

Yes, but the mere fact of his existence does not prove he was the Son of God. It’s a necessary first step to attempting to prove that but, as I said, the fact that a person by that name existed doesn’t prove the rest of the necessary steps any more than it proves that Mohammed was really hearing from God.

@Another Holocene Human: Persuasion at this point is probably hopeless. What might work is a large scale public shaming program, similar to what happened with smoking. Notably, that vice has been virtually eradicated in many urban areas.

I wouldn’t be surprised if there’s an environmental factor, which makes me even more suspicious of the anti-vaxxers. It’s easy to point the finger at individual parents and their decisions, but an environmental factor would make that easy blame much, much harder.

FWIW, my niece and nephew are both on the spectrum, with my nephew being slightly more affected, but it’s very clearly genetic for them, because my brother-in-law (their maternal uncle) is high-functioning but on the spectrum himself.

I suppose that most who comment here are progressive types. Some are even liberals. Many, if not all, of those probably agree with President Obama as he has stated many times that access to healthcare is a fundamental human right. I know, I do.

So when I read this…

When every pediatrician refuses to care for kids that haven’t been vaccinated….

…excuse me if I feel a fair amount of disdain to those who would want to block children from access to a fundamental human right. That is approaching a Bill O’Reilly level of moral savagery.

What to do? Treat the kids. It’s not their fault and even if it were…find a way to care for them. It is inhumane to use them as leverage as mistermix advocates up top.

You want a scary waiting room?

Envision an urban free AIDS clinic in the early 90’s. There were some serious fucking microbes flying around. I know because I sat in those rooms as a patient. They dealt with it in a variety of ways and procedures and it worked.

There are so many ways to successfully, safely (for others), and humanely treat any youngsters who have been so let down by their parents that the mind reels at the reactionary silliness I see above.

There is more (oh joy, right?) but I do not want to have too many reply links.

Let’s extend the AIDS metaphor you brought up. Would an AIDS doctor be justified in dropping one of his patients because the patient refused to use a condom or inform any of his partners that he has AIDS, or must that doctor continue to see that patient regardless of that patient’s actions that endanger himself and others?

If you are saying the doctor could deny treatment or care (or be so justified)…

Wouldn’t that be like the wingers I have heard saying that fat inner city welfare moms and their chubby pre-diabetic children should not be soaking up public health resources if they can’t quit the fried foods and soda pop?

If one starts down the road of denying access to medical care because of behavior…one is starting down a very troubling road indeed.

Now that I volunteer with an AIDS community medical/hospice service org, I will tell you that those doctors will not deny care, though they may alter care to what fits the limits of the patients lifestyle and what the standard of treatment indicates.

If one starts down the road of denying access to medical care because of behavior…one is starting down a very troubling road indeed.

I’m asking what you think a doctor’s options should be when they have a noncompliant patient. Should the doctor be forced to continue to treat that patient no matter what, or should the doctor be able to say, You know, this isn’t working out.

Again, we’re not talking about the bad old days when doctors would freak out that their patient had AIDS and refuse to treat them because of their fears or moral judgement about the disease. But if a doctor has a patient with COPD who refuses to stop smoking, can the doctor tell that patient he won’t see him/her anymore, or is the doctor stuck with a noncompliant patient for all time?

Now that I volunteer with an AIDS community medical/hospice service org, I will tell you that those doctors will not deny care, though they may alter care to what fits the limits of the patients lifestyle and what the standard of treatment indicates.

So, just to be clear, if a patient tells those doctors that they’re not taking their HIV meds and are having casual sex without condoms, the doctors have no qualms about keeping that person as their patient? We’re not talking about treating people within their lifestyle limits — we’re talking about patients who refuse to follow doctor’s orders.

ETA: Not just not following doctor’s orders, but in the case of the theoretical AIDS patient and the anti-vaccination parents, actively endangering others by their actions.

Certain behaviors are going to drop one to the bottom of some organ transplant wait-lists, no? Doesn’t the 12-year old whose situation isn’t quite as dire as the 50-year old chronic alcoholic is going to get the first shot at that liver that suits them both?

@Mnemosyne: You’re attempting to debate with someone playing the role of contrarian moral scold. It’s Friday. Tell him to fuck off with his false equivalence bullshit, rent a movie you’ve been dying to see, and enjoy it with a tasty meal and some adult beverages.

I had a dentist fire me once. I was taking care of my dad, bringing him to chemo etc and cancelled a dentist appt. They called up to make a new one. I told them the situation, and that shortly I could make all kinds of appts, just not right now.

They sent me a letter saying I was not fulfilling my obligation to their practice. I had thought my obligation consisted of me paying promptly for service. Apparently not.

The other issue with firing vaccine-noncompliant patients is that they are also likely to be noncompliant in other areas, including the “reasonable accommodations” KeithG is talking about. An epidemiologist who comments at Respectful Insolence (a medical blog famous for its anti-antivaxxer stance) shared this story, which I think is illustrative of just why pediatricians might want to make antivaxxers unwelcome for noncompliance reasons:

This one person I know who used to work at a busy family practice had a non-vaccinating family as patients. The mom and dad in the family had been told that they were welcomed to bring their kids to the practice with one caveat: They had to call before they came in so that they would not go into the waiting room and go in the back door and into the far rear room, which also had negative pressure to it. The practice did not want to risk measles or chickenpox in the waiting area because there were several children being seen there who had immune deficiencies. (One had leukemia and was being treated. I forget what the other two had.)

On more than one occasion, the mother showed up with the five unvaccinated children (ages toddler to second grader) into the waiting room and to the front desk. She didn’t call or put masks on the kids. One of those times, she brought in the children because SHE HAD TAKEN THEM TO A CHICKENPOX PARTY AND THEY WERE FEVERISH. I wish I was joking.

The problem with asking pigheaded people who don’t think they’re doing anything wrong to stop doing things that might endanger other people is that, because they don’t think they’re doing anything wrong, they don’t see any reason to listen to you. Not only that, but most antivaxxers believe diseases like measles and chicken pox are basically harmless, so there’s no reason for even immune-compromised children not to be exposed to them. (The ones who do recognise rare complications sometimes even go so far as to say that kids who die from complications were weak and deserved it.)

People die from that kind of thinking. The AIDS clinic analogy is basically false at its core because you’re not talking about just mitigating infection transmission, you’re also talking about mitigating denialism.

For specifics you would need a professional – And I will ask during my next day on.

Standard of care takes into account a patients ability and willingness to be compliant. All the 31 antiretroviral drugs currently in use must be taken under a fairly unvarying routine to be effective. A doctor would be reluctant to follow a treatment course that would not be effective.

What is more, allowing a patient to begin a treatment course when that patient is unable/unwilling to follow the course would be harmful for the patient. That is because an incomplete treatment regime would lead to a resistant virus which would then leave this patient with fewer options in a year or two when the individual might be willing and able to adhere to the protocols.

So assuming the basics of your hypothetical, the doc would be expected to not re-establish HAART therapy until some assurance of compliance to the course of therapy. But I do not see any doctor I know refusing to treat that patient in others way…nor do I think it is ethical.

There are other things to do on a regular basis for that patient. For example: Test for TB; Flu shots; test and treat any other STDs and Hep C; Hep A & B vaccinations. And so on.

@Mnemosyne: The difference is that the noncompliant patient with HIV is not endangering the physician’s other patients in the waiting room. An unvaccinated child may be. Those who are endangered by a noncompliant AIDS patient are not the doc’s responsibility the way the kids waiting to see their pediatrician are.

Of course, I’m old enough that my pediatrician lost quite a few families because he saw patients in the order they arrives, unless triage trumped by a sicker child. What they looked like was unimportant to him. Those other “integrated” practices was patients in the order of their melanin content.

The AIDS clinic analogy is basically false at its core because you’re not talking about just mitigating infection transmission, you’re also talking about mitigating denialism.

True. If we want to keep it in the realm of AIDS patients, the correct analogy might be having a patient come in and announce that he had stopped taking his antivirals because he had read online that HIV and AIDS don’t have anything to do with each other, so there was no reason for him to take them. Not only that, if he did come down with something infectious, like the flu or TB, he would see no reason why he should be isolated from the other patients in the waiting room — after all, since HIV doesn’t really exist, he can’t possibly make them sick just by being sick himself.

It’s still a fairly stretched analogy, but the basic question remains: what does a doctor do if a patient is putting other people at risk and the patient refuses to believe that his/her actions are putting others at risk in the first place?

Not the unvaccinated- or at least not all of the unvaccinated- but those who refuse vaccination. There are valid reasons for not being vaccinated, like being allergic to components in the vaccine; people with egg allergies are told not to get flu shots for exactly that reason. And unvaccinated kids aren’t the ones who are unreasonable; it’s their parents who deserve the blame.

I have a very liberal friend who insists the flu vaccine just gives you the flu and is useless. She’s not anti-vaccine, but rants every flu season about the flu vaccine.

And: the problem is that she is probably no altogether wrong: my wife (who has immune-system issues) refuses to get the flu vaccine each year, since she is convinced (on good past evidence) that the effects of the vaccine, and the (possible) effects of the flu are about equal: so the odds don’t – in this case – figure.

But that’s THE FLU: [obligatory IANAImmunologist disclaimer] – AFAIK, influenza is caused by a type of rapidly-mutating virus (or viruses) which can can change from year-to-year: measles (again, AFAIK), isn’t the same: and vaccination CAN (if more-or-less universal) kill the disease off in large part: with “herd immunity” being a large part of it.

But then, most anti-vaxxers seem to have that inbred characteristic of the extremist/fanatic: when reality clashes with their pet dogma, it becomes “obvious” to them that reality is wrong, and they tend to double down on the dogma. If children’s lives/health weren’t involved it would be mock-worthy…..

@Mnemosyne: The skeptic’s mantra is usually, “Extraordinary claims require extraordinary evidence”. Universe creator God incarnates Himself in the womb of a virgin as a man with the ability to perform miracles then raises himself from the dead? OK, those are some extraordinary claims. There is nothing in the Gospels or anywhere else that should convince a skeptic of any of that. I don’t think there could ever be documentary evidence to convince a skeptic of any of that. Even if tomorrow somebody digs up a document, written in Aramaic, plausibly dated to 32CE that appears to be the diary of Thomas explaining how it felt to stick his hand into Jesus’s spear wound, it shouldn’t be enough to convince a skeptic of any of that.

BUT…

Charismatic Jewish preacher from the 1st century amasses a following, pisses off Roman authorities and gets himself crucified for his trouble? Those are not extraordinary claims. That probably happened every third Friday. The burden of proof should be much, much lower. Actually, I think the burden of proof flips. The people who insist there never was any such person are in the position of conspiracy theorists. Sure, their story is possible, but I don’t think it’s the way to bet.

I think Interrobang has a good point, though — patients who are convinced they know better than their doctors (ha, that stupid doctor thinks vaccines work, but I know better!) will probably be noncompliant in all kinds of ways because they’re convinced they always know best. After all, if you’re convinced that measles won’t be bad for your kids and will only make them stronger, why would you try to prevent other people’s kids from getting it, too? It’s good for them!

The difference is that the noncompliant patient with HIV is not endangering the physician’s other patients in the waiting room.

Sorry, but you are plainly and completely wrong.

In the rooms I have experienced, coughing/wheezing patients will be clearly directed to take a face mask. There are some really sick folks who show up…I have seem some triaged to side/isolated waiting areas…a few have been triaged right to the nearest ER. The staff is very careful and proactive about any situation that might pose issues to other patients Coughing/fluid/personal waste. It is all about training and commitment. They have been doing this for a very long time.

We don’t have to find a way to accommodate the treatment of those children?

Put yourself in the position of the doctor in the story in Interrobang
This is the antivax mom who comes into the waiting room with 5 feverish kids who’ve been to a chickenpox party.
Whether or not it is real (I’m guessing real), a doctor has to assume this sort of thing will happen with kids who have an antivax parent. Since they operate in a free market medical system (excepting the VA), they get to make choices about things like this.

And, frankly, I’m guessing that kind of behavior would be something that would set them apart from a parent whose child is physically incapable of being vaccinated — that parent would be more than happy to bring their child through the back door, get directly into a room, etc. to avoid the possibility of their own unable-to-be-immunized child catching something in the waiting room.

And now they can diagnose autism in the first month of life before vaccines are even administered.

So, so, so very late to this thread, but my autistic daughter was showing signs of echolalia– repeating things we said– aged SIX WEEKS OLD. Six weeks. So whenever anyone asks me if it was the vaccines, I a) resist the urge to headbutt them and b) point out that the signs were there before anyone ever so much as waved a needle at her.

NYC parent of a preschooler here- he got his second MMR dose this week three months early (we live not too far from Washington Heights, where most of the cases have been). His pediatrician, who is the best, told me the MMR is effective in the majority of kids after the first dose; the second dose is to try to catch the kids for whom it didn’t take the first time. But she was happy to have us come in the same day I called and give him the second shot as a precaution. While we waited in the lobby, I overheard the staff fielding a lot of calls from parents who were on the “delayed schedule.” While I do, of course, hope nothing happens to the kids, I do wish those parents a lot of worry and regret while the epidemic runs its course.

The vaccine schedule is set with a view towards maximizing vaccine effectiveness and minimizing the chance of side effects. Some vaccines have a higher chance of fever or seizures the later they’re given because the immune system is more developed. Fever and seizures are usually harmless, but good grief, why risk the kid being any more uncomfortable than necessary? I only wish they’d develop a vaccine for Cosackie, because that suuuuuucks.

@Bill Arnold: I’m old enough and so are my kids that we all got chickenpox when we were young. There was no vaccine back then.

When I got sick with them my mom figured that’s what it was but wanted confirmation so she called and was told to bring me to the back door of the practice. The doc stuck his head out and said, “Yup, chickenpox”.

A little girl who was in my daughter’s nursery school was blind in one eye because of the chickenpox, got one pox on her optic nerve. A teacher at my son’s HS died of chickenpox when he got them in his lungs. It is a fucking serious disease.

I’ve posted this before but I’ve had all the “normal” childhood illness other than polio that we now vaccinate for because I am old enough. Not one of them was fun in any way and one of course left me open for it’s follow up, shingles, which of course I’ve had as well. Yes I lived through them but I don’t wish them on anyone. I mentioned polio specifically because I’ve known 3 people with it. Girl I went to school with K-12(who is one of my personal heroes, and I don’t have many of those), a kid in cub scouts mom, and another friends mom. And they have a shot for these that keeps people from getting them? And I’m going to turn it down, for me or my kids? Are these people out of their fucking minds?

@Keith G:
Are the people in the waiting rooms made to wear masks because they are compromised or to avoid compromising others, or both? As I understand it HIV leaves your immune system pretty weak and being so weakened allows one to pick up other diseases that can be very harmful to a compromised person. It’s not so much that HIV is transmitted as an aerosol(as I understand it) it is that life with HIV can allow things that won’t kill a normal person to harm someone with it. I didn’t die from flu, mumps, measles, or chickenpox or shingles, but if I had HIV I probably would have.
Every time I’ve gotten a flu shot I’ve gotten sicker than when I’ve caught the flu so I don’t get it. But I’m getting old and that alone makes getting the flu a lot more dangerous so I may not be able to skip the shot anymore.

@Capri: My daughter is in a pediatric practice that vaccinates all children except for medical contraindications.

If you have an egg allergy, they’ll special order the eggless flu vaccine. You’ll have to come to an appointment instead of the clinic, but you’ll get your vax.

I (and my daughter) have a contraindication to the smallpox vaccine. They finally gave me one when I was 11 years old (possible exposure through a pilot we knew), and I was sick for two weeks. They wouldn’t give her the vax unless there was a likely exposure.

The pediatric practice won’t vaccinate kids with a fever; they won’t give a shot if you’ve got a possible problem until they’ve tested for it, and if you have a true contraindication, you won’t be tossed from the practice. They’re counting on herd immunity for all the rest of the kids to protect the kids who can’t be vaccinated.

However, if you go in and say, “Don’t give my kid the MMR because it causes autism”, you will be told to find another doctor. “Give us 15 minutes and we’ll hand you your kids’ medical records to pass on.” No, they’re not punishing the (unvaxed) kid, they’re protecting the 6-day-old babies entering the practice, as well as the kids with contraindications.

WarriorGirl’s private school, like her preschool, has the same policy. Vaccinate or show a medical contraindication. Or go somewhere else.

Up here in Romneycare land, you can call your insurer and ask for them to help you find a doctor in their network that fits your needs. And I know for a fact that they will tell you which practices will accept children whose parents don’t want them vaccinated. {Two moms at the library talking about trouble finding a doctor. I kid you not.}